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Emergency Radiology
Published in: Emergency Radiology 1/2019

01-02-2019 | Review Article

Blunt traumatic vascular injuries of the head and neck in the ED

Authors: Elizabeth George, Ashish Khandelwal, Christopher Potter, Aaron Sodickson, Srinivasan Mukundan, Diego Nunez, Bharti Khurana

Published in: Emergency Radiology | Issue 1/2019

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Abstract

Cerebrovascular injury is increasingly identified in patients presenting after blunt trauma due to the implementation of screening criteria and advances in noninvasive angiographic imaging by CT. The variable latent time before onset of secondary stroke presents a window of opportunity for prevention, reinforcing the importance of detection of asymptomatic patients via screening. Furthermore, the high morbidity and mortality associated with secondary stroke makes it imperative that radiologists recognize these challenging injuries. This article reviews the epidemiology of and the various proposed screening criteria for blunt cerebrovascular injury. The imaging findings of extra- and intracranial vascular injuries, including arterial and venous trauma, are reviewed along with the grading system. Conservative management with anticoagulation has gained favor over the years with intervention restricted to high-grade injuries such as transection and hemodynamically significant arteriovenous fistula. Many of these injuries also evolve over time, with or without anticoagulation, necessitating imaging follow-up.
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Metadata
Title
Blunt traumatic vascular injuries of the head and neck in the ED
Authors
Elizabeth George
Ashish Khandelwal
Christopher Potter
Aaron Sodickson
Srinivasan Mukundan
Diego Nunez
Bharti Khurana
Publication date
01-02-2019
Publisher
Springer International Publishing
Published in
Emergency Radiology / Issue 1/2019
Print ISSN: 1070-3004
Electronic ISSN: 1438-1435
DOI
https://doi.org/10.1007/s10140-018-1630-y

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